The present invention relates to identification bracelets and more particularly to a disposable bracelet having an embedded electronic memory and a reusable transceiver which is releasably attachable to the bracelet for receiving data from a remote source to be stored in the memory and transmitting data stored in the memory to a remote receiver.
Throughout time accurate patient identification has been a paramount concern in administering medication to, and performing medical procedures on, a patient. Years ago patient identification was relatively simple as local doctors would provide all types of medical care for essentially every person within a small community and knew each patient personally.
However, in today's medical environment, patient identification is a much more arduous task for many reasons. First, literally hundreds of patients are examined and treated on a daily basis in large modern medical facilities, each doctor or nurse interacting with as many as twenty or more patients within a single day. With such high traffic unaided positive patient identification is nearly impossible for any doctor or nurse.
Second, many medical facilities are expansive including specialized departments which are spread out throughout the facility, many departments being on different floors or even in different buildings. For example, diagnostic examination, imaging, surgery, recovery, etc., areas are all usually separate and staffed by different personnel. As a patient is moved from one department to another, even if personnel within one department can visually identify a patient, personnel in another department may not be able to identify the patient.
Third, many patients are admitted into a medical facility for a period which is longer than a single shift. Where facility personnel changes during a patient's stay, unaided patient identification would be nearly impossible.
Fourth, in many cases medical personnel cannot rely on a patient for correct identification. Some patients might be experiencing severe trauma, be under the influence of medication or be asleep, thereby making positive identification verification impossible.
For years the standard for patient identification has been to place an identification bracelet on each patient's wrist. One bracelet includes a clear plastic sleeve having first and second ends and a paper strip. Information including a patient's name, an identification number and perhaps primary appearance characteristics (e.g. eye color, hair color, height, weight, etc.), are printed on a viewing surface of the strip. The strip is inserted in the sleeve with the viewing surface observable through the sleeve. The two ends of the sleeve are integrally joined using a mechanical fastener thereby forming a ring around the patient's wrist. These bracelets are designed to be removed only by cutting so that once a bracelet is placed on a patient, the bracelet cannot mistakenly be placed on another patient. In addition, these bracelets are inexpensive enough that they are disposable.
While these bracelets are helpful, often it is difficult to read information from the paper strips within the sleeves as the sleeves often hinder viewing, the paper strips slide inside the sleeve and can even become folded or crimped within the sleeve.
Recently, new plastic materials and new printing methods have been developed which enable printing directly on plastic surfaces. In addition, new adhesives have been developed which are used to fasten bracelet ends together. This new technology has facilitated single piece bracelets wherein identification material is printed directly on a viewing surface of a plastic strap and the strap is secured around a patient's wrist using an adhesive.
A patient's bracelet is used by all medical facility personnel to identify a patient. Prior to administering a medication a nurse or doctor reads the patient's name from the bracelet and compares the patient's name with the name of the patient for whom the medication was dispensed. The patient's name is usually printed either on a medication order or on a paper enclosed with the medication in a container or bag.
In addition, prior to performing any medical or diagnostic procedure, facility personnel also use the bracelet to identify a patient. For example, a person recording an electrocardiogram (EKG) to be sent to a computerized storage system will often be instructed to provide, via a keyboard, a patient's name and identification number from the bracelet. Both the name and number are often requested as a misspelling of the name is a fairly common mistake and the identification number provides redundant identification.
For the purpose of this explanation, printed plastic bracelets will be described as printed bracelets. While printed bracelets have improved identification, printed bracelets have a number of important shortcomings. First, only a small amount of information can be printed on a bracelet. In this regard, unless a person viewing identification information has a medical history file in his/her possession, the person cannot identify immediate medical status of a patient (e.g. medication to be administered, time to administer medication, recent medical procedures, symptoms, etc.).
Second, information on a plastic bracelet cannot automatically be transferred to electronic instrumentation such as an EKG machine, an imaging machine, etc. where a medical instrument requires patient information, the information must be manually provided by facility personnel.
Third, each time a patient must be identified, the doctor, nurse or orderly identifying the patient must pick up the patient's wrist and rotate the wrist or the bracelet to a position wherein the identification information is observable. While this simple procedure is not in and of itself difficult for a person to perform or extremely bothersome to a patient; when the procedure must be performed a dozen or more times each day, the cumulative effect can be both bothersome to the patient and burdensome to the person who has to identify the patient.
Fourth, once information has been printed on the bracelet, the information cannot be changed and additional information cannot be added. This may not be important during short stays at a medical facility because printed information likely will not change appreciably over a short period. However, during a long stay at a facility, some printed information, in particular primary appearance characteristics (e.g. weight, etc.), may change and therefore should be updated.
One way in which to transfer identifying information from a bracelet to a medical instrument is to provide identifying information in bar code form. Bar codes, however, also have short-comings. While a bar code provides a machine readable format, only a limited amount of information can be represented by a bar code. This is because bar codes typically require as much space per represented character than the conventional alphabet. While smaller codes are possible, smaller codes are extremely difficult to read. In addition, practically, only a certain length of bar code is possible given the natural curve of a patient's wrist and the requirement that the code be essentially flat during scanning. In addition, like conventional printing, bar codes cannot be modified and therefore bracelet information cannot be modified after a bar is printed. Because a bar code cannot be read unless it is essentially flat, a bar code, to a greater extent than conventional print, requires special placement of a patient's wrist to read represented information. Furthermore, non-contact bar code reading devices are relatively expensive and often it takes several attempts to read a code accurately.
U.S. Pat. No. 5,493,805 describes an identification device including a memory "button" or chip which may be embedded within a bracelet, the bracelet worn by a patient. Identification information is electronically stored in the chip and can be accessed by use of a hand held instrument, preferably by simply touching the chip with a probe or the like. In addition to the electronically stored information, basic patient information can be printed on the bracelet for visual observation by a person. Preferably, the chip has a robust construction so that it is removable from the bracelet without being damaged and is then erasable, sterilizable and reusable to identify another patient. However, despite the chips robust construction, this patent contemplates that the chip might be disposable after a single use. Chip disposal is preferred over reuse as reuse might be perceived as unsanitary and may therefore be objectionable. This is particularly true where a patient has a communicable disease or expires while wearing a bracelet. For the purposes of this explanation, a bracelet including a simple memory chip will be referred to herein as a memory chip bracelet.
Memory chip bracelets overcome many of the problems associated with printed bracelets. For example, assuming a well designed memory chip, memory chip bracelets facilitate storage of a relatively large amount of information. In addition, memory chip bracelets facilitate modification of stored information. Moreover, memory chip bracelets facilitate transfer of information from the chip by simply touching the chip via a probe.
Unfortunately, memory chip bracelets also have several shortcomings. First, as with printed bracelets, identifying a patient wearing a memory chip bracelet still requires a doctor, nurse or orderly to position the chip in some orientation where good chip contact can be made. Because a memory chip includes a relatively large amount of information, in many cases the chip will be used more often than printed identification information to access needed information. For example, with a printed bracelet, the bracelet is used only to identify a patient and other information about the patient is usually accessed from some other source (e.g. a computer or a patient file).
With a memory chip bracelet, medicine administration history, treatment history, symptoms, diagnostic history, etc., may all be stored on the chip. Upon entry into a patient's room, the chip may be used once for identification and a second time for medicine or treatment history or to retrieve some other information. The chip may be used one or more additional times to access other information. Repeated chip readings are burdensome.
Second, where memory chips are reusable, despite sterilization there could still be a perception of unsanitary conditions rendering reusable chips objectionable.
Third, where memory chips are reusable, there is a possibility that chip information might not be erased or may only be partially erased prior to being used to identify another patient. Such a mistake could lead to erroneous identification and ultimately to incorrect treatment or diagnosis.
Fourth, chip removal, erasing, sanitizing, reinsertion into a new bracelet and rewriting to identify another patient is a burdensome and relatively expensive procedure, the cost and bother of which probably is not justifiable during all medical facility visits. For example, a ten minute visit probably would not justify such a costly and time consuming procedure.
The U.S. Pat. No. 5,493,805 patent also contemplates a bracelet wherein the chip includes an integral antenna for transmitting information to a hand held device. The preferred transmitter is a radio frequency transmitter wherein an external coil generates a field which provides energy to the chip within the field for transmitting information to the hand held device. Another chip embodiment might include a transmitter and a separate power source (e.g. a battery) providing power to the transmitter for transmitting information. For the purposes of this explanation, bracelets including a transmitter embedded in a chip will be referred to as transmitting bracelets.
Transmitting bracelets eliminate the need for reorientating a bracelet or a patients arm to access information from a chip. However, even transmitting bracelets have several shortcomings. First, while a memory on a chip may be inexpensive, transmitting circuitry on a chip increases chip costs appreciably. While bracelet costs may be defrayed by reusing the transmitting chip as indicated above, even after sterilization, reuse might be perceived as unsanitary and might therefore be objectionable. For these reasons, relatively expensive transmitting bracelets may only be justifiable in instances where a patient is admitted for an extended period and printed bracelets may be more suitable under other circumstances.
Second, as with memory chip bracelets, where a transmitting chip is reused, there is always the danger that a portion of the memory might not be erased prior to rewriting and patient identification or information could be confused.
Third, if a bracelet is designed properly, it is difficult to remove a chip from a bracelet. In patient identification, it is important that a chip be attached to the bracelet so that it cannot inadvertently be removed, dislodged or replaced. If a chip is to be reused, the chip has to be removed despite integral attachment. For this reason, a chip must be securely lodged within and integral with the bracelet to prohibit inadvertent removal. Integral attachment makes removal difficult at best and may require special tools (as recognized in the U.S. Pat. No. 5,493,805 patent), further increasing identification system costs.
Fourth, where a chip has to be removed from a bracelet for sterilization, the chip could be damaged or even destroyed during removal, rendering the chip useless. While damaged memory chips might be inexpensive and therefore disposable, damaged transmitting chips represent appreciable cost.
Fifth, in the alternative, instead of removing a chip from a bracelet, the entire chip and bracelet could be sterilized and the chip erased for reuse. It is even more likely, however, that this option would be perceived as unsanitary. In addition, while the chip could be erased and rewritten, printed identification information on the bracelet could not be easily erased and reprinted.
Sixth, a transmitting chip may be damaged in certain environments. For example, such a chip might not be waterproof and therefore would be damaged during bathing. In addition, a transmitter chip may be susceptible to magnetic or electric fields (e.g. MRI) within a medical environment. Similarly, a transmitter chip might give off a field of its own which could interfere with diagnostic or treatment fields.
Seventh, during extended hospitalization periods, a chip battery might need to be replaced. Replacing a battery while a bracelet is attached to a patient would be difficult at best.
When bathing, within a treatment or diagnostic energy field, or to replace a battery, a bracelet could be removed. However, removal is undesirable because a removed bracelet could be confused with another bracelet. In addition, because bracelets are constructed so that they cannot be easily removed, usually a bracelet would have to be destroyed to be removed.
Moreover, it is contemplated that during a stay at a medical facility, only rarely is it necessary to remove a patient's identification bracelet and therefore, if removed, typically removal is inadvertent and unintended. Currently no system is known for indicating when a medical bracelet is inadvertently removed despite the need for patient identification at all times.
Eighth, a bracelet which includes a transmitter assembly is often relatively bulky. For example, see U.S. Pat. No. 5,793,290 which describes one wrist band transmitting device. Unfortunately, while a bulky device may not be objectionable to a relatively healthy and strong patient, many patients are relatively unhealthy and relatively weak. This is particularly true in the case of patients who remain in a facility for a long duration. Other generally weak facility occupants include infants and small children. For these patient types a bulky transmitter assembly is uncomfortable and generally objectionable.
For all of the reasons discussed above, it would be advantageous to have a patient identification mechanism which is inexpensive, disposable, rewritable, permanent during a patient's stay at a medical facility and accessible without reorientating a patient or the bracelet.